Comparison between the use of hydrocolloids (xanthan gum) and high-pressure processing to obtain a texture-modified puree for dysphagia.

Enriched lentil protein vegetable purees (10% zucchini, 10% carrots, 2.5% extra virgin olive oil and 21.8% lentil protein concentrate) suitable for people with dysphagia were developed with 0.8% xanthan gum (XG) or 600 MPa/5 min high pressure processing (HPP) treatment with the aim of comparing their rheological and textural properties. Selection of the appropriate XG % and HPP conditions was made by performing initial pilot trials. Purees showed a good nutritional profile (12% protein, 3.4% fiber, 100 Kcal/100 g), being adequate for people with dysphagia. Microbiological testing of HPP treated purees indicated that it has a good shelf-life under refrigerated conditions 14 days). Both types of purees showed a gel-like character (tan delta 0.161-0.222) and higher firmness, consistency and cohesiveness than control samples. Comparing XG and HPP samples at time 0, HPP treated purees showed the highest stiffness ( G'), the lowest deformability capacity (yield strainLVR) and the lowest structural stability (yield stressLVR). With storage, HPP treatment samples showed significant increases in all rheological and textural parameters. These results confirm the suitability of HPP as an alternative technology to hydrocolloids for the obtained dysphagia dishes.

Application of HPP for the Development of a Dessert Elaborated with Casein and Cocoa for a Dysphagia Diet.

In this study, the application of high-pressure processing (HPP) for optimizing the texture of a cocoa dessert rich in casein and developed for people with dysphagia was investigated. Different treatments (250 MPa/15 min; 600 MPa/5 min) and protein concentrations (10-15%) were combined and evaluated for choosing the optimum combination leading to an adequate texture. The selected formulation was a dessert containing 4% cocoa and 10% casein and subjected to 600 MPa for 5 min. It showed a high nutritional value (11.5% protein) and high antioxidant capacity, which was slightly affected by the HPP processing. The rheological and textural properties showed that HPP had a clear effect on the dessert structure. The loss tangent decreased from 2.692 to 0.165, indicating the transition from a liquid to a gel-like structure, which is in a suitable range for dysphagia foods. During storage (14 and 28 days at 4 °C), progressive significant changes in the structure of the dessert were observed. A decrease in all rheological and textural parameters occurred, except for the loss of tangent, which increased its value. In any case, at 28 days of storage, samples maintained the weak gel-like structure (0.686 loss tangent) that is acceptable for dysphagia management.

Exploring Tools for Designing Dysphagia-Friendly Foods: A Review.

Dysphagia is a medical condition that affects normal swallowing. To prevent the risk of aspiration or choking, thickened fluids and texture-modified foods have been used for dysphagia management with the goal of slowing down the flow of liquids and protecting the airway. This article summarizes the available information about the rheological and textural parameters, the characterization of the most-used thickeners and the application of alternative texture modification technologies that are crucial to developing safe dishes for people who suffer from swallowing difficulties. Regarding rheological and textural measurements, fundamental and empirical methods are described.

Conflict between Children's Autonomy and Protection in Healthcare. Comparative Study between Spanish and Belgian Law.

This article addresses the autonomy of children and adolescents in healthcare decisions, focusing on those ones that might entail a risk to the child's life or health, especially when a medical intervention is refused. In these cases, a conflict between the recognition of the autonomy of the child and his or her protection arises, and various legal systems solve it in different ways. This study examines this issue from a comparative perspective between Belgian and Spanish laws, taking into account that the latter was rewritten in 2015 to leave out all underage patients' decisions that could constitute a risk for their life or health.

Content of medical information and unpredictable results in Spanish law.

In this study we consider the problem of content of medical information the patient must receive before a medical treatment. Specifically, Spanish law doesn't clarify if doctors must inform patients about every known risk or consequence inherent to an operation, or only about the most probable ones. There have been several contradictory judicial decisions of the Supreme Court about this, and in some cases it's been affirmed that the duty of information is not absolute, while in other decisions it's been affirmed just the opposite.